永川区全民食盐加碘前后甲状腺功能亢进症发病分析

摘要

目的 分析全民食盐加碘(USI)对重庆市永川区甲状腺机能亢进症(简称甲亢)医院病例发现率变化的影响.方法 以1990～2009年在重庆医科大学附属永川医院确诊的甲亢病例为调查对象,所有病例以彩超(或者黑白B超)检查甲状腺大小,计算其容积和甲状腺肿大率.结果 共发现甲亢病例4 714例,年均发现率为22.58/10万,USI前(1990～1996年)发现414例,年均发现率为5.9/10万,USI后(1997～2009年)发现4 297例,年均发现率为31.2/10万,USI后的发现率显著高于 USI前,USI后医院甲亢发现率呈上升趋势.随着USI时间的推移和甲亢患者年龄升高,甲亢患者的甲状腺容积逐渐缩小,其肿大率下降.女性发病多于男性(2.8∶1),病例主要集中在30岁组,占35.8%(1 689/4 714),其次为40岁组,占24.0%(1 130/4 714).结论 在重庆市永川区,医院甲亢发现率随USI呈上升趋势,可能与碘过量有关.%Objective To investigate the occurrence of hyperthyroidism affected by universal salt iodization(USI)in Yongchun district,Chongqing city. Methods The residents with hyperthyroidism diagnosed in Yongchun district were investigated during 1990-2009 in our hospital. Based on laboratory examinations,the cases were confirmed as hyperthyroidism with increase of TT3 (PT3)or TT4(FT4) ,decrease of TSH and symptoms of hyperthyroidism. All cases were determined the size of thyroid by colorful ultrasound and calculated the volume of thyroid and rate of thyromegaly. Results 4 714 cases were diagnosed as hyperthyroidism,annual average of incidence(AAI)was 22.58/100000. Before USI(1990-1996),AAI was 5.9/100 000(414 cases)while AAI was 31.2/100000(4297 cases)after USI(1997-2009). The occurrence of hyperthyroidism following USI was significant higher than that without USI and incidence of hyperthyroidism at hospital was increasing. Along with USI period extending and patients' age in creasing, the volume of thyroid was concomitantly decreased, so did thyromegaly. The cases in female were more than Chose in male (2.8 vs 1)and most of the cases concentrated on 30 years old group,accounting for 35. 8％(1689/4714) ,followed by 40 years old group,accounting for 24.0％(1130/4714). Conclusion The incidence of hyperthyroidism at hospital in Yongchuan dictricit is in creasing, which may be correlated with excess of iodine intake.